The Soaring Costs of Alzheimer’s Care

As a generation of baby boomers continues to grow older, costs of care for Alzheimer’s disease and other forms of dementia are expected to soar in the coming decades, from an estimated $159 to $215 billion in 2010 to more than twice that amount in 2040. The estimates come from the Health and Retirement Study, a large and ongoing study of Americans age 51 and older that began in 1992. They represent the most rigorous analysis to date of how much it costs to care for someone with dementia.

The researchers, from the RAND Corporation, estimated that individual costs for dementia care are among the highest of any disease, ranging from $41,000 to $56,000. Most of that cost comes from nursing home care as well as formal home care, as well as the informal home care supplied by family members and friends of people with Alzheimer’s.

The direct costs of caring for Alzheimer’s and other forms of dementia were even higher than that for heart disease and cancer, other chronic ailments that take a major toll on society. The findings were published in the New England Journal of Medicine.

The researchers note that tracking the costs of dementia care is difficult for a variety of reasons. For one thing, people with Alzheimer’s are more likely than those without dementia to be older and to have coexisting medical problems, such as stroke or depression. In their analysis, they sought to account for these coexisting conditions in order to estimate the costs of dementia alone.

In addition, much of the care that Alzheimer’s patients receive is unpaid care provided by family members and friends, who often help with feeding, dressing, bathing, grocery shopping, managing medications and other activities of daily living. It can be difficult to put a monetary figure on this informal care.

The federal government is seeking to arrive at better estimates of the costs of Alzheimer’s care in order to plan for the predicted surge in costs in coming decades. In January of 2011, President Barack Obama signed into law the National Alzheimer’s Project Act, one goal of which is to better track the monetary costs of dementia care provided by public programs like Medicare and Medicaid.

The analysis found that about 15 percent of the population over age 70 had Alzheimer’s disease or another form of dementia. That translates into about 3.8 million Americans, with the total expected to exceed 9 million by 2040. No other chronic disease is showing such a surge in numbers.

In addition, another 22 percent of seniors aged 71 and older, or 5.4 million people, had mild cognitive impairment, a form of memory loss that often precedes dementia. About 12 percent of those with mild cognitive impairment go on to develop full-blown Alzheimer’s or dementia each year.

The study found that the direct medical costs of dementia in 2010 were $109 billion, compared to $102 billion for heart disease care and $77 billion for cancer care. Additional costs due to informal care for dementia ranged from $50 billion to $106 billion. Those costs included the amount that a family member or friend might be paid if they were hired to do the same work from an in-home health care agency, as well as lost wages, since caregivers must often give up jobs and employment in order to care for a loved one with Alzheimer’s disease.

Experts note that the caregiving costs for Alzheimer’s are higher than for other chronic medical conditions because caregiving is often intensive and round-the-clock. The staggering figures highlight the urgent need for better ways to treat, prevent and cure Alzheimer’s disease and other forms of dementia.